Interventional Gastroenterology Unit, Department of Internal Medicine, University Hospital Centre "Sestre Milosrdnice", Vinogradska 29, Zagreb, 10000, Croatia.
Obes Surg. 2011 Oct;21(10):1597-604. doi: 10.1007/s11695-011-0414-1.
Ghrelin and leptin recently emerged as the most influential neuroendocrine factors in the pathophysiology of obesity. The said peptides act in reciprocity and are responsible for regulation of appetite and energy metabolism. Intragastric balloons acquired worldwide popularity for obesity treatment. However, the roles of ghrelin and leptin in intragastric balloon treatment were still not systematically studied.
A prospective single-center study included 43 Caucasians treated with BioEnterics intragastric balloon, with age range of 18-60, and divided to non-morbid (body mass index cutoff 40 kg/m(2)) or morbid type of obesity, with 12 months follow-up. Serum hormonal samples were taken from fasting patients and kept frozen until analyses.
Significant differences were observed in anthropometrics and there were no differences between genders or comorbidities. The baseline weight for non-morbid vs. morbid was 104 kg (90-135) vs. 128.5 kg (104-197). Weight loss was statistically different between the studied groups during the study course with a median control weight at 6 months of 92 kg (72-121) vs. 107 kg (84-163), p < 0.001. Treatment was successful for 18 (94.7%) vs. 16 (66.7%) patients, p = 0.026. Ghrelin varied from 333.3 to 3,416.8 pg/ml and leptin from 1.7 to 61.2 ng/ml, with a statistically significant time-dependent relationship. A significant difference (p = 0.04) with emphasized ghrelin peak was found in the 3rd month of treatment for non-morbidly obese subjects.
The importance of ghrelin and leptin in treatment-induced changes was reaffirmed. Ghrelin hyper-response in non-morbidly obese subjects characterized greater short-term treatment efficiency and landmarked an inclination to weight regain. The results suggest a potential pattern of individualization between obese patients according to body mass index towards intragastric balloon or bariatric surgery. Further studies are needed in order to get better insights in the pathophysiologic mechanisms of obesity.
Ghrelin 和 leptin 最近成为肥胖病理生理学中最具影响力的神经内分泌因素。这些肽在相互作用中发挥作用，负责调节食欲和能量代谢。胃内气球在全球范围内广泛用于肥胖治疗。然而，ghrelin 和 leptin 在胃内气球治疗中的作用仍未得到系统研究。
一项前瞻性单中心研究纳入了 43 名接受 BioEnterics 胃内气球治疗的高加索人，年龄在 18-60 岁之间，分为非病态（体重指数截止值为 40 kg/m2）或病态肥胖类型，随访 12 个月。空腹患者采集血清激素样本，冷冻保存至分析。
在人体测量学方面观察到显著差异，且性别或合并症之间无差异。非病态组与病态组的基线体重分别为 104 公斤（90-135）和 128.5 公斤（104-197）。在研究过程中，两组之间的体重减轻存在统计学差异，中位控制体重在 6 个月时为 92 公斤（72-121）和 107 公斤（84-163），p<0.001。治疗成功的患者分别为 18 名（94.7%）和 16 名（66.7%），p=0.026。Ghrelin 从 333.3 到 3416.8 pg/ml，leptin 从 1.7 到 61.2 ng/ml，呈统计学上的时间依赖性关系。在非病态肥胖患者的第 3 个月治疗中，发现 ghrelin 峰值有显著差异（p=0.04）。
再次证实了 ghrelin 和 leptin 在治疗诱导变化中的重要性。非病态肥胖患者的 ghrelin 高反应性特征表明短期内治疗效率更高，并倾向于体重反弹。这些结果表明，根据体重指数，胃内气球或减肥手术可能会对肥胖患者进行个体化治疗。需要进一步研究以更好地了解肥胖的病理生理机制。
